| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF COLORADO, LLC | 4582 S ULSTER ST STE 600 DENVER, CO 80237 | HARTFORD LIFE AND ACCIDENT | $15K | — | $15K | 3.48% |
| ASSUREDPARTNERS3 Filed as: ASSUREDPARTNERS OF COLORADO, LLC | 4582 S ULSTER ST STE 600 DENVER, CO 80237 | VISION SERVICE PLAN | $3K | — | $3K | 2.40% |
| AMY E GRIFFIN3 | 5110 GRANITE ST STE A LOVELAND, CO 80538 | AFLAC | $455 | $20 | $475 | 3.18% |
| JOHN W BELL3 | PO BOX 270550 FORT COLLINS, CO 80527 | AFLAC | $251 | — | $251 | 1.68% |
| LAURA M MARCOTTE3 | 4928 SILVERWOOD DR JOHNSTOWN, CO 80534 | AFLAC | $123 | $5 | $128 | 0.86% |
| CHRISTINE A EDGERTON3 | 23135 NW POND RD BUXTON, OR 97109 | AFLAC | $95 | — | $95 | 0.64% |
| WENDY M SHELLY3 | 9947 CORBRIDGE ST LAS VEGAS, NV 89178 | AFLAC | $78 | — | $78 | 0.52% |
| KATRINA R DOCKTER3 | 2414 O ST APT 1 SACRAMENTO, CA 95816 | AFLAC | $67 | — | $67 | 0.45% |
| DANIEL L FRENCH3 | 240 43RD AVE GREELEY, CO 80634 | AFLAC | $54 | — | $54 | 0.36% |
| MATTHEW J MITTAN3 | PO BOX 71 SWANNANOA, NC 28778 | AFLAC | $52 | — | $52 | 0.35% |
| COLISTA R SHETLER3 | 2418 PEBBLE SPRINGS CT HENDERSON, NV 89074 | AFLAC | $42 | — | $42 | 0.28% |
| JOHN P THOMPSON3 | 6395 S KEWAUNEE WAY STE 425 AURORA, CO 80016 | AFLAC | $32 | — | $32 | 0.21% |
| ALAN LECLAIRE3 Filed as: ALAN R LECLAIRE | 28 GEORGETOWN FORT MYERS, FL 33919 | AFLAC | $29 | — | $29 | 0.19% |
| ROBERT C BERTRAM3 | 9265 COUNTY ROAD 57 KEENESBURG, CO 80643 | AFLAC | $29 | — | $29 | 0.19% |
| JONATHAN SAMUEL KIRKLAND3 | 1270 HOPEWELL CRST ALPHARETTA, GA 30004 | AFLAC | $25 | — | $25 | 0.17% |
| LINDA ANN RASKIND3 | 9710 MALVERN DR TAMARAC, FL 33321 | AFLAC | $17 | — | $17 | 0.11% |
| STEPHEN B THACKSTON3 | 20050 OAK RD E UNIT 301 GULF SHORES, AL 36542 | AFLAC | $16 | — | $16 | 0.11% |
| MARY R HAUGHT3 Filed as: MARY KIMBERLY KUXHAUSEN | 2016 VAN BUREN AVE LOVELAND, CO 80538 | AFLAC | $15 | — | $15 | 0.10% |
| KYLE PROBASCO3 | 4928 SILVERWOOD DR JOHNSTOWN, CO 80534 | AFLAC | $15 | — | $15 | 0.10% |
| THERESA NETTO PHILLIPS3 Filed as: THERESA A CHAMBLISS | 2059 PINE RIVER DR KINGWOOD, TX 77339 | AFLAC | $14 | — | $14 | 0.09% |
| SUSAN RUSSELL3 | 120 ROCKWOOD DR HENDERSONVILLE, NC 28792 | AFLAC | $13 | — | $13 | 0.09% |
| SERAPIO M. NAMBO3 Filed as: SERAPIO M NAMBO | 2175 57TH AVE SACRAMENTO, CA 95822 | AFLAC | $12 | — | $12 | 0.08% |
| RIGGS COUNSELMAN MICHAELS & DOWNES3 Filed as: GARRY RIGGS | 950 SOUTHRIDGE GREENS BLVD UNIT 30 FORT COLLINS, CO 80525 | AFLAC | $9 | — | $9 | 0.06% |
| SHARMAIN L BOUNDS3 | 2202 TEDESCA DR HENDERSON, NV 89052 | AFLAC | $9 | — | $9 | 0.06% |
| DAVID E SCHMIDT3 | 331 SAN MARCO WAY SAINT PETERS, MO 63304 | AFLAC | $9 | — | $9 | 0.06% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF COLORADO, LLC | 1873 S BELLAIRE STREET #600 DENVER, CO 80022 | AFLAC | $9 | — | $9 | 0.06% |
| JAMES S SARANTIS3 | 14132 SE FIRCREST CT PORTLAND, OR 97236 | AFLAC | $8 | — | $8 | 0.05% |
| RYAN L STOOKEY3 | 1 METCALF DR BELLEVILLE, IL 62223 | AFLAC | $8 | — | $8 | 0.05% |
| JOSE DE LOS SANTOS III3 | 15550 E COPPER CREEK LN PARKER, CO 80134 | AFLAC | $7 | — | $7 | 0.05% |
| DIANA CABRAL RENTCHLER3 | PO BOX 54 WEST SACRAMENTO, CA 95691 | AFLAC | $6 | — | $6 | 0.04% |
| TINA WAY3 | 15550 E COPPER CREEK LN PARKER, CO 80134 | AFLAC | $5 | — | $5 | 0.03% |
| KENT HORSMAN3 | 1600 STIFEL WOODS DR CHESTERFIELD, MO 63017 | AFLAC | $4 | — | $4 | 0.03% |
| TANYA L MARTINSON3 | 6395 S KEWAUNEE WAY AURORA, CO 80016 | AFLAC | $4 | — | $4 | 0.03% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: DANIEL A JAIME | 1150 GUSTINE ST CHULA VISTA, CA 91913 | AFLAC | $3 | — | $3 | 0.02% |
| BARRY A WHITE3 | 4506 BANTAM WAY ELK GROVE, CA 95758 | AFLAC | $2 | — | $2 | 0.01% |
| ALLISON FARRIS WENDELBERGER3 | 207 SANTA FE DR WALNUT CREEK, CA 94598 | AFLAC | $2 | — | $2 | 0.01% |
| G SCOTT COOKE3 Filed as: SCOTT E NIELSEN | 718B W FOURTH PLAIN BLVD VANCOUVER, WA 98660 | AFLAC | $2 | — | $2 | 0.01% |
| JOHN W AMOS3 Filed as: JOHN P THOMPSON JR | 236 HAVERSHAM RD DELTONA, FL 32725 | AFLAC | $2 | — | $2 | 0.01% |
| LAWRENCE A ELMORE3 | PO BOX 244 MORRISON, CO 80465 | AFLAC | $2 | — | $2 | 0.01% |
| MICHAEL C WALKER3 Filed as: MICHAEL M STASTNY | 605 PORTLAND AVE UNIT 531 GLADSTONE, OR 97027 | AFLAC | $2 | — | $2 | 0.01% |
| ERIC DANIEL WEILAND3 | 14511 SW CORNERSTONE LN SHERWOOD, OR 97140 | AFLAC | $1 | — | $1 | 0.01% |
| WILLIAM B KRZCIOK3 | 2760 FORT MYER AVE HENDERSON, NV 89052 | AFLAC | $1 | — | $1 | 0.01% |
| LINDA BAILEY3 Filed as: LINDA G BAILEY | 6505 DEADERICK CT ORANGEVALE, CA 95662 | AFLAC | $1 | — | $1 | 0.01% |
| BRADLEY K HARRISON3 | 3432 W TRUMAN BLVD JEFFERSON CITY, MO 65109 | AFLAC | $1 | — | $1 | 0.01% |
| ROBIN M CALLAWAY3 | 10201 W MARKHAM ST STE 203 LITTLE ROCK, AR 72205 | AFLAC | $0 | — | $0 | 0.00% |
| BRIAN D NEUNER3 | 7651 E HIGHWAY WW COLUMBIA, MO 65201 | AFLAC | $0 | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AMERIBEN / IEC GROUP EIN 84-1225570 THIRD PART ADMIN | Claims processing; Contract Administrator Service code 12 | — | $245K |
| COMPSYCH CORPORATION EIN 36-3739783 EAP ADMIN | Claims processing; Contract Administrator Service code 12 | — | $18K |
| PAYLOCITY ADMIN FEES | Contract Administrator; Claims processing Service code 12 | 2302 INTERNATIONAL LN MADISON, WI 53704 | $8K |
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 795 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 22 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 822 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 767 | $33K |
| Vision | VISION SERVICE PLAN | 490 | $124K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 795 | $428K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 795 | $428K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 795 | $428K |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 795 | $443K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 795 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
No prospect flags tripped on this filing.